kOBCS�: A Novel Software Calculator Program Of The Objective Breast Cosmesis Scale (OBCS) (Preprint)

BACKGROUND The Objective Breast Cosmesis Scale (OBCS) was introduced as an objective method to document the breast cosmetic changes using non-standardized photographs without scale-calibration. OBJECTIVE This work test the accuracy and reproducibility of the kOBCS© software tool which invented to simplify the measurement of the OBCS values. METHODS to prove the mathematical accuracy five schematic drawings of breast-shaped figures were digitally photographed and imported into the kOBCS©. Thirty different photos of breast cancer patients were imported into kOBCS©, twenty different users (experts and non-experts) used the program to evaluate the photographs on two different occasions one week apart. Additionally, a subjective evaluation of each photo was performed throughout the evaluation panel using the Harvard breast cosmesis scale and the results were categorized in two groups; favorable versus adverse cosmesis. RESULTS The OBCS values as estimated by the kOBCS© ranged between 1.5 and 13.0 with median value of 4.6. There is a highly significant correlation between the OBCS values based on hand measurements and the OBCS values estimated by the kOBCS©, both values correlate nearly 100% (r= 0.997, p<0.001). There is a strong correlation between the repeated measurements for each user, indicating reliable reproducibility of the program in estimating the OBCS values. Agreement among the users using the kOBCS© was strong with high statistical significance (ICC=0.846, p<0.001, 95% CI: 0.774-0.910, Cronbach’s alpha=0.991). Results of the subjective analyses and mean OBCS values as estimated by kOBCS© correlated significantly (r=0.961, p<0.001). CONCLUSIONS The kOBCS© is a reliable and reproducible easy-to-use software for reporting breast cosmesis following BCT. The kOBCS© offers a wide range of potential use in different clinical studies that report on the breast cosmesis as one of the outcomes.